1st Department of Obstetrics and Gynecology School of Medicine National and Kapodistrian University of Athens
The female genital malformations, that are frequent but not always detected, constitute a genuine barrier in fertilization and at the same time a cause of verbal confusion in medical understanding. Up until now, the systems that have been proposed for their classification are the American Fertility Society (AFS), the American Society of Reproductive Medicine (AFS, 1988) and the Vagina, Cervix, Uterus, Adnexa and associated Malformations (VCUAM, 2005) system.
The main dilemma with female genital malformation classifications is, that exclusively on the basis of Mullerian embryologic classifications we cannot explain, detect or treat other female genitourinary malformations or even if these malformations are recognized, they are described so simply or complexly that they are of no assistance.
Since the combination of malformations, occurring at different stages of development, seems to be the reason for the extremely wide anatomical variations, systems with greater clarity and potential uniformity will help in treatment, prognosis and certainly in pregnancy outcome.
The European Society of Human Reproduction and Embryology (ESHRE)/European Society for Gynaecological Endoscopy (ESGE) proceeded to a consensus in 2016 for the classification system of female genital anomalies, in which detailed information about the available diagnostic techniques, their advantages, disadvantages and recommendations regarding their proper use were provided. Our readers can enjoy a comprehensive review in the current issue. As doctors Grimbizis and Makedos mentioned, a certain amount of time will be needed in order for all clinicians to deal with the investigation of the female genital malformations, so as to start commonly using the new classification system and its recommendations.